Comparison of Deep Venous Thrombosis Following Femoral Versus Internal Jugular Catheterization in Hemodialysis Patients

Muhammad Ishfaq  Ahmad; Muhammad  Yasir; Bilal  Rasheed; Asim  Mushtaq; Muhammad Waqas Ahmed  Qureshi; Moniba Saeed  Sheikh

doi:10.51253/pafmj.v75i6.10365

Authors

Muhammad Ishfaq Ahmad Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Yasir Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Bilal Rasheed Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Asim Mushtaq Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Muhammad Waqas Ahmed Qureshi Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Moniba Saeed Sheikh Department of Dermatology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i6.10365

Keywords:

Chronic Kidney Disease, Deep Venous Thrombosis, Femoral Catheterization, Hemodialysis, Internal Jugular Catheterization.

Abstract

Objective: To compare the frequency of deep venous thrombosis associated with femoral and internal jugular venous catheterization in patients undergoing hemodialysis.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Sep 2022 to Feb 2023.

Methodology: All patients undergoing hemodialysis, regardless of gender, who were 30-60 years old, were considered for inclusion. Patients were divided randomly. In Group-A, patients underwent hemodialysis through femoral vein catheterization. In Group-B, patients underwent hemodialysis through internal jugular vein catheterization. Following the insertion of the catheter, patients were monitored for any signs of deep vein thrombosis on each visit. Doppler ultrasound examination was conducted before the insertion of the dual-lumen central catheter, subsequent to its removal, and one week following catheter removal.

Results: The total of 60 patients were enrolled in the study. Patients who were enrolled in Group-A, had mean age 40.80±8.69 years. Patients who were enrolled in Group-B, had mean age 44.15±9.04 years. In Group-A, 8(26.7%) patients developed deep vein thrombosis. In Group-B, none of the patients developed DVT. The difference in the group was significant (p=0.002).

Conclusion: Hence, femoral vein catheterization is linked to a greater risk of DVT than internal jugular vein catheterization.

Downloads

Download data is not yet available.

References

1. Al-Balas A, Lee T, Young CJ, Kepes JA, Barker-Finkel J, Allon M. The Clinical and Economic Effect of Vascular Access Selection in Patients Initiating Hemodialysis with a Catheter. J Am Soc Nephrol 2017; 28(12): 3679-3687.

https://doi:10.1681/ASN.2016060707

2. Qureshi M, Rashid S, Qamar M, Moon F, Danial K, Abid K. Causes of Mortality in End Stage Renal Disease Patients in a Single Haemodialysis Center. Life Sci 2023; 16; 4(1):5.

3. Beecham GB, Aeddula NR. Dialysis Catheter. Treasure Island (FL): StatPearls Publishing; 2025 Available from:

https://www.ncbi.nlm.nih.gov/books/NBK539856/

4. Sachdeva B, Zulfiqar H, Aeddula NR. Peritoneal Dialysis. Treasure Island (FL): StatPearls Publishing; 2022.

5. Huriaux L, Costille P, Quintard H, Journois D, Kellum JA, Rimmelé T. Haemodialysis catheters in the intensive care unit. Anaesth Crit Care Pain Med 2017; 36(5): 313-319.

https://doi:10.1016/j.accpm.2016.10.003

6. Sharma M, Tong WL, Thompson D, Vachharajani TJ. Placing an appropriate tunneled dialysis catheter in an appropriate patient, including the nonconventional sites. Cardiovasc Diagn Ther 2023; 13(1): 281-290. https://doi:10.21037/cdt-22-426

7. Vo HM, Syeda R, Ali M. Inferior Vena Cava Placement of a Transhepatic Tunneled Dialysis Catheter in a Patient with Atypical Hepatic Venous Anatomy: A Case Report. Cureus 2024; 16(9): e69365. https://doi:10.7759/cureus.69365

8. Gunawansa N, Sudusinghe DH, Wijayaratne DR. Hemodialysis Catheter-Related Central Venous Thrombosis: Clinical Approach to Evaluation and Management. Ann Vasc Surg 2018; 51: 298-305. https://doi:10.1016/j.avsg.2018.02.033

9. El Khudari H, Ozen M, Kowalczyk B, Bassuner J, Almehmi A. Hemodialysis Catheters: Update on Types, Outcomes, Designs and Complications. Semin Intervent Radiol 2022; 39(1): 90-102.

https://doi:10.1055/s-0042-1742346

10. Reindl-Schwaighofer R, Matoussevitch V, Winnicki W, Kalmykov E, Gilbert J, Matzek W, et al. A Novel Inside-out Access Approach for Hemodialysis Catheter Placement in Patients With Thoracic Central Venous Occlusion. Am J Kidney Dis 2020; 75(4): 480-487.

https;//doi:10.1053/j.ajkd.2019.08.024

11. Trottier SJ, Veremakis C, O'Brien J, Auer AI. Femoral deep vein thrombosis associated with central venous catheterization: results from a prospective, randomized trial. Crit Care Med 1995; 23(1): 52-59.

https://doi:10.1097/00003246-199501000-00011

12. Huang Y, Chen B, Tan G, Cheng G, Zhang Y, Li J, et al. The feasibility and safety of a through-and-through wire technique for central venous occlusion in dialysis patients. BMC Cardiovasc Disord 2016; 16(1): 250.

https://doi:10.1186/s12872-016-0411-3

13. Abrantes C, Soares E, Valério P, Furtado T, Barreto C. Hemodialysis Catheter-Related Thrombi: A Challenging Patient. Cureus 2020; 12(6): e8438.

https://doi:10.7759/cureus.8438

14. Regmi S, Manandhar D, Pyakurel S, Shrestha B, Khanal P, Paudel S, et al. Central Venous Catheter-related Thrombosis in a Dialysis Patient: A Case Report. J Nepal Med Assoc 2022; 60(251): 648-650. https://doi.org/10.31729/jnma.7603

15. Drakos P, Ford BC, Labropoulos N. A systematic review on internal jugular vein thrombosis and pulmonary embolism. J Vasc Surg Venous Lymph Disord 2020; 8(4): 662-666.

https://doi.org/10.1016/j.jvsv.2020.03.003

16. Duffett L, Kearon C, Rodger M, Carrier M. Treatment of Superficial Vein Thrombosis: A Systematic Review and Meta-Analysis. Thromb Haemost 2019; 119(3): 479-489.

https://doi:10.1055/s-0039-1677793

17. Siciliano F, Ronconi E, Rossi T, Fanelli F, Krokidis M, Sirignano P, et al. Endovascular treatment of lower limb acute DVT: current trends and future directions. CVIR Endovasc 2024; 7(1): 82.

https;//doi:10.1186/s42155-024-00495-x

18. Durbec O, et al. Lower extremity deep vein thrombosis: a prospective, randomized, controlled trial in comatose or sedated patients undergoing femoral vein catheterization. Crit Care Med 1997; 25(12): 1982-1985.

https://doi:10.1097/00003246-199712000-00013

19. Boccatonda A, Di Vincenzo F, Olivieri I, D'Ardes D, Lessiani G, Di Gregorio N, et al. Internal Jugular Vein Thrombosis: A Bicentric Cohort Study. J Clin Med 2025; 14(11): 3626.

https://doi:10.3390/jcm14113626

20. Kitano D, Yonezawa K, Iwae S, Sakakibara S. Internal jugular vein thrombosis and pulmonary thromboembolism after head and neck reconstructive surgery. J Plast Reconstr Aesthet Surg 2021; 74(6): 1239-1245.

https;//doi:10.1016/j.bjps.2020.11.007

21. Saha DK, Nazneen S, Ahsan AA, Saha M, Fatema K, Ahmed F, et al. Comparison of Central Venous Catheter-Related Deep Venous Thrombosis According to Insertion Site in an Intensive Care Unit of Bangladesh. J Medicine 2022; 23(1): 20-23.

https://doi.org/10.3329/jom.v23i1.57932

22. Scerrati A, Menegatti E, Zamboni M, Malagoni AM, Tessari M, Galeotti R, et al. Internal jugular vein thrombosis: etiology, symptomatology, diagnosis, and current treatment. Diagnostics 2021; 11(2): 378.

https://doi.org/10.3390/diagnostics11020378

23. Lok CE, Huber TS, Lee T, Shenoy S, Yevzlin AS, Abreo K, et al. National Kidney Foundation. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update Am J Kidney Dis 2021; 77(4): 551.

https;//doi:10.1053/j.ajkd.2021.02.002